A review of available surgical techniques to accelerate orthodontic tooth movement

Abstract

Corticotomies have been used to assist orthodontic treatment since the late 18th century. This review describes and compares different surgical techniques available to accelerate tooth movement: PAOO™, Corticision, Piezocision™ and Propel. All of the approaches described accelerate orthodontic tooth movement and may protect against root resorption. PAOO™ and Piezocision™ offer the option of bone and soft tissue grafting at time of surgery. Corticision, Piezocision™ and Propel are considered minimally invasive procedures thanks to the flapless approach, but the use of the mallet in Corticision could constitute a trauma for the patient. The piezoelectric knife creates a more intense Regional Accelleratory Phenomenon (RAP) at the site of injury due to the effect of high frequency vibrations. This suggests that Piezocision™ could create a greater effect on bone remodeling, hence producing faster tooth movement and extended RAP. The lack of randomized controlled clinical trials makes an effective comparison between these techniques difficult and future studies are needed to better evaluate the outcomes of each of these.